Comparing Traumatic Brain Injuries to Psychological Injuries

A traumatic brain injury (TBI) is defined as a blow or injury to the head that shakes the brain within the skull.

Fort Lauderdale, FL (prHWY.com) January 18, 2013 - Since the War on Terror began, many workers have traveled to either Iraq or Afghanistan to assist the United States in rebuilding efforts. Unfortunately, many of these workers have been exposed to the horrors of war. Some workers have suffered physical injuries, while others have reacted psychologically to the stresses of war and working in a war zone. There are also some workers who have been exposed to concussive blasts from bombings and explosions. Many blast injuries do not result in an observable physical injury and, as a result, the injury is either ignored or misdiagnosed. Occasionally, concussive blast injuries to the head (also known as a traumatic brain injury) are misdiagnosed as a psychological injury. However, oftentimes appropriate treatment for a traumatic brain injury is psychological counseling. This article is intended to assist in understanding the difference between a purely psychological injury and a traumatic brain injury.

A traumatic brain injury (TBI) is defined as a blow or injury to the head that shakes the brain within the skull. Doctors will commonly describe this as a concussion which can range from mild to severe. Bruising, swelling, or tearing of brain tissue can possibly occur as well. Either a direct trauma to the head, or exposure to the concussive blast emanating from an improvised explosive device (IED) or mortar attack, can result in a traumatic brain injury. It bears mentioning that the diagnosis and treatment for this, particularly where concussive blasts are involved, is a developing area of expertise which is still not completely understood by the medical community.

There are many different symptoms that can result following an injury to the head. After suffering one, many people complain of an inability to think clearly, experience difficulty recalling new information, forgetfulness, headaches, vision problems, dizziness, feeling sad, feeling nervous, being easily angered, and even develop a change in sleeping habits. Unfortunately, because there is no observable physical injury, many individuals do not seek immediate medical assistance. As time goes by, without medical care, the effects of the traumatic brain injury worsen and individuals become more frustrated and angry. By the time medical attention is sought, the primary medical complaints may appear to be psychological in nature because the injured person tends to complain about current problems without correlating and connecting them to the prior traumatic event. This can lead to an improper diagnosis of a psychological injury while failing to address the organic basis for the symptoms being experienced.

In order for a doctor to conduct a proper analysis, it is extremely important that the prior traumatic events be disclosed and discussed in detail with the medical provider. The doctor should ask questions about your ability to focus and recall information, your ability to pay attention, your ability to learn, and your ability to solve problems. The doctor may also check your reflexes, strength, balance, coordination, and sensation. In order to determine if there is any bruising or bleeding of the brain, the doctor may also order diagnostic tests such as an MRI, MEG scan, or CT scan.

When a traumatic brain injury is diagnosed, treatment may include physical therapy, speech and language therapy, counseling, or participation in support groups. Additionally, medications may be prescribed to assist with sleep issues, anxiety, depression, or even memory problems. Rest is also considered one of the best ways to recover from a traumatic brain injury. Long after the diagnosis and treatment, a person may still suffer from headaches, diminished capacity to concentrate and focus, problems with expression or communication skills, persistent anxiety or depression, and problems with sleep. In extreme cases, some people may develop fears about the loss of safety or control of their life, become estranged or obsessive, and abuse drugs and alcohol. When this occurs, the medical providers will begin treatment for post traumatic stress disorder (PTSD).

Clearly, treatment for a traumatic brain injury often includes psychiatric and psychological counseling. This distinction is important to understand. An individual can suffer a psychological injury without a trauma to the head or brain. Stress can lead to a psychiatric diagnosis of depression or anxiety. Where a person experiences horrors of war which cause them to fear death or severe injury, they may be diagnosed and treated for post-traumatic stress disorder (PTSD). However, the psychiatric diagnosis and treatment stem from a stressful experience which is distinguishable from a traumatic brain injury. Psychiatric and/or psychological counseling is one of many treatments available to an individual who has suffered a traumatic brain injury. Many individuals with traumatic brain injuries refuse to accept psychiatric treatment because they fear being stigmatized as "crazy". The failure to secure appropriate treatment may only delay and hinder the recovery. Others fail to recognize a traumatic brain injury, but again are hesitant to acknowledge something is wrong. They typically become frustrated, angry, and tend to disassociate with others. As the frustration and anger increases, they put additional stress on the brain. This additional stress may result in organic changes in the brain which can ultimately lead to an incorrect clinical diagnosis.

The prefrontal cortex in our brain acts as the control center. This is a critical functioning part of the brain. Its essential function is to keep basic emotions and impulses balanced. When an individual experiences acute stress, a series of chemical reactions take place which weaken the functioning of the prefrontal cortex and transfer some of the processes to older parts of the brain. When this occurs, individuals experience significant anxiety or engage in impulsive behavior such as excessive drinking or use of drugs. Researchers do not know why stress causes the brain to weaken high functioning cognition resulting in anxiety and impulsive, excessive behavior.

If an individual suffers a traumatic brain injury and fails to secure treatment, it is quite possible that living with the long-term effects may cause one to suffer additional stress. The persistence of problems with focus, concentration, headaches, blurred vision, memory, etc., may result in an individual subjecting their brain to acute stress. By the time help is sought, an individual may be suffering from anxiety and depression. This becomes the condition that is treated, while the underlying organic basis (i.e. TBI) is ignored. As such, it is extremely important to reveal any prior history of trauma to the brain when seeking medical care so that an accurate diagnosis can be made and the proper treatment protocol provided.

Defense Base Act attorneys Barnett & Lerner, P.A. has established itself, during the last several years, as the leader and innovator in representing injured workers suffering from psychological and traumatic brain injuries who are eligible to receive Jones Act workers compensation. The trial and appellate court decisions that define and provide guidance regarding psychological and traumatic brain injury cases were all successfully handled by Barnett & Lerner, P.A. Some examples include S.K. v. SEII where the trial and appellate courts agreed that the medical diagnosis must be determined by the doctor and not by psychological testing results or manuals. In the case of L.R. v. KBR, the trial and appellate courts both agreed that if the medical doctor advises that there is no psychological impairment or restrictions, but further advises against returning to work in a war zone, the injured worker is entitled to compensation benefits for any loss of earning capacity. In E.M. v. DynCorp, the firm established the right to compensation benefits even when there is a significant delay between the accident or events and the worker's recognition of a disabling psychological injury. More specifically, E.M. was shot at work but did not fully appreciate the psychological impact until almost two years later. The employer and insurance carrier denied E.M. compensation benefits, asserting her claim was untimely. The trial court and two appellate courts disagreed with the employer and their carrier. These rulings, along with many other cases litigated by Barnett & Lerner, P.A., have served to define the current status of psychological injury claims under the Defense Base Act.

###

Tag Words: None

Categories: Business

Press Release Contact
2860 Marina Mile Blvd. Suite 105, Fort Lauderdale , FL

Link To This Press Release:

URL HTML Code